Ideally, workplace accidents would never happen. Unfortunately, even the safest workplaces experience employee injuries. If you were hurt in a workplace accident, you may have questions about your ability to get reimbursement for medical bills and lost income through workers’ compensation. You may wonder, “Can I get compensation if I caused my injury?” Typically, workers’ compensation coverage is “no-fault” meaning that an employee is covered even if he or she was at fault for the accident or injury. However, there are exceptions to this rule.

Criteria for Workers’ Compensation Coverage in California

To know if you can get financial reimbursement through workers’ compensation, you must first determine if you qualify for workers’ compensation coverage. Employers with one or more employees are required to have workers’ compensation insurance per California law. Full-time, part-time, and seasonal employees are covered by workers’ compensation. If you are an independent contractor, you most likely do not qualify for reimbursement through workers’ compensation.

Circumstances of the Injury

Another factor that determines whether you get compensation through workers’ comp is the circumstances of the injury. Normally, fault does not influence an employee’s eligibility for workers’ compensation. If your own mistake caused the accident or injury, you are most likely still covered. However, the injury must have taken place while you were performing work duties.

When most people think of workers’ compensation claims, they picture a worker suffering from a broken leg or a back injury. While physical injuries do make up the majority of workers’ compensation claims in California, many workers also suffer from psychiatric injuries caused by traumatizing work incidents. Firefighters, police officers, and other first responders are at an especially high risk of psychological injuries. These workers are often witness to extremely upsetting situations involving gruesome injuries, death, and other tragedies. However, psychological injuries can occur to workers in any profession.

California Workers’ Compensation Law Regarding Emotional or Psychological Harm

Employers in California are required to carry workers’ compensation insurance. Employees who suffer an on-the-job injury are typically entitled to compensation for medical bills and a portion of their lost income. California workers’ compensation covers physical injuries as well as certain work-related emotional and psychological injuries.

California law requires employers to carry workers’ compensation insurance. This insurance is designed to cover medical bills and partial lost wages for workers who are hurt on the job. California law also prohibits employers from retaliating against employees who have filed a workers’ compensation claim. Employers cannot fire or otherwise discriminate against a worker simply because he or she filed for workers’ compensation. Victims of workers’ compensation discrimination may be entitled to job reinstatement, additional financial compensation, and reimbursement for lost wages.

What Actions Are Considered Discriminatory?

Some employers are irritated by an employee filing a workers’ compensation claim – even when the employee has a legitimate work injury and is rightfully entitled to workers’ compensation benefits. The employer may take out this frustration on the employee by treating him or her differently than the other employees. Not only is this practice unethical, it is also unlawful. Employers who discriminate against an employee because of a workers’ compensation claim, settlement, or award are guilty of a misdemeanor criminal offense.

Examples of actions that may constitute workers’ compensation discrimination or retaliation include:

While some professions are more dangerous than others, a workplace injury can happen to anyone. Some work injuries are the result of a one-time incident such as a slip and fall or equipment-related accident. Other injuries are caused by months or years of repetitive stress on certain body parts. Whatever the cause, work-related accidents can incur a significant financial burden on injured workers and their families. Workers’ compensation is intended to relieve this financial burden, however, workers’ compensation is not available to all workers. Supporters of Senate Bill 216 say that the legislation is one step toward making workers’ compensation available to a greater number of California workers.

Supporters of SB-216 Say That Many Contractors Lie About Having Employees

California law requires employers to carry workers’ compensation insurance. However, contractors who do not have employees are exempt from this requirement. Of the nearly quarter-million contractors in California, over half report no employees. However, some believe that many of these contractors are lying. The author of SB-216, California State Senator Bill Dodd, has stated that contractors who falsely claim exemption increase the cost of workers’ compensation for others. This gives the contractors an unwarranted financial advantage over other contractors. Moreover, these falsifications leave injured workers without the protection they deserve. The costs associated with ambulance transportation, hospitalization, and ongoing medical needs resulting from a work injury can quickly add up to staggering amounts. When combined with lost wages from missed work, a serious work injury can nearly bankrupt an injured worker.

Legislation Aims to Provide Immediate Coverage to Workers in Construction, HVAC, and Related Fields

The proposed legislation would immediately require contractors in the heating, air conditioning, concrete, and tree service industries to obtain workers’ compensation insurance. The rest of the licensed contractors in California would need to get coverage by 2025. This would ensure that workers who are hurt on the job have access to the financial compensation they need. Contractors who violate the proposed legislation would be subject to license suspension and even misdemeanor criminal charges.

It is hard to believe, but spring is just around the corner in Santa Clara. While many welcome the warmer weather, it is important to consider the effect that the heat can have on workers. Heatstroke, heat exhaustion, heat syncope, and heat cramps can affect both outdoor workers and indoor workers in high-risk occupations. According to the Centers for Disease Control and Prevention (CDC), approximately 700 heat-related deaths occur in the United States each year. Heat illness also leads to thousands of non-fatal injuries including injuries sustained because of fainting. Those who are hurt may be able to recover damages through a workers compensation or personal injury claim depending on the details of their case.

OSHA Guidelines for Safe Work Environments

California is known for its warm, sunny weather. Unfortunately, working in hot environments can lead to serious and even fatal injuries. The Occupational Safety & Health Administration (OSHA) states that 50 – 70 percent of heat-related fatalities occur during the initial days of working in warm conditions when the body has not yet acclimatized to the hot environment. OSHA has established guidelines for employers with workers in outdoor or indoor environments that involve hot environments, heavy physical activity, or heavy clothing. Workers in certain industries are often at particularly high risk of heat-related illnesses and injuries, including those who work in:

This year has been unprecedented, to say the least, especially when it comes to safety in the workplace. As COVID-19 hit the United States, most businesses went fully remote, and almost one year later, many are still working from home. Those considered essential workers, however, were not given this option. Essential workers have been placed at a much higher risk of contracting COVID-19 than those who have been granted the benefit of keeping their job while also working remotely. The state of California recognized this and granted additional protective measures to those on the frontlines. With the vaccine now being administered, many workplaces are requiring their employees to get the vaccine before returning to work. Getting the vaccine may protect against COVID-19, but it has also left many with serious side effects and wondering if workers’ compensation is an option.

Senate Bill 1159

California legislature released Senate Bill 1159 back in September 2020, which states that COVID-19 may be considered a work-related illness, making employees eligible for workers’ comp, if the following conditions are met:

Those who are injured at their workplace have certain rights outlined by the state of California, regardless of the nature of their position. There are a number of misconceptions about California’s workers’ compensation policy, including the assumption that this financial assistance is solely reserved for those in especially dangerous fields such as construction. It is important to have an understanding of your rights as you join the California workforce since a single injury can leave you in physical and financial disarray. 

1. What Should I Do If I Have a Work Injury?

After any type of injury, it is common to “wait it out” to see if reporting the injury or seeking medical treatment is truly necessary. Perhaps you slipped on wet floors or have a gash on your arm from improperly stowed tools and believe that your injuries are fairly minor. Regardless of the nature of your injury, you should immediately report the injury to your employer and seek medical treatment. This report will ensure that the nature of your injuries is recorded from the onset and prevent you from problems and delays in receiving benefits.

Construction sites are some of the most dangerous work environments that exist. Workers must often work with hazardous materials, atop scaffolds and rooftops, and among heavy machinery and dangerous equipment. It is for these reasons that construction workers suffer catastrophic injuries and fatalities at much higher rates than workers in other professions. If you or a loved one were injured while working at a construction site in California, it is essential to know your rights. You may be entitled to compensation by filing a workers’ compensation claim as well as through a third-party claim.

Workers’ Compensation for Construction Accidents

The Occupational Safety & Health Administration (OSHA) lists falling, being struck by objects, electrocution, and caught-between accidents as the top four causes of fatal construction site accidents. Traumatic events often lead to severe injuries on construction sites; however, repetitive stress injuries that develop over time are also commonly suffered by construction workers. Back and spine injuries are typically caused by repetitively lifting objects, working in awkward positions, or uneven weight distribution on tool belts. California workers’ compensation covers traumatic injuries in addition to repetitive motion injuries.

When people think about workers’ compensation injuries, they often imagine sudden injuries that occur in a fall or other traumatic accident. However, accident-related injuries are not the only types of injuries covered by California workers’ compensation. Individuals suffering from repetitive stress injuries or repetitive motion injuries may also be entitled to compensation. Office workers are often vulnerable to injuries caused by typing and other office work. However, it is sometimes difficult for injured office workers to receive the compensation they deserve.

Carpal Tunnel Syndrome and Other Repetitive Motion Injuries

The most common office-related repetitive stress injury is carpal tunnel syndrome. Typing on a computer keyboard, filing, and other office tasks require repetitive hand and wrist motions. This can put too much pressure on the median nerve and can cause painful symptoms including numbness, tingling, weakness, and pain. Medical conditions such as diabetes, rheumatoid arthritis, and thyroid disorders increase a worker’s chances of developing carpal tunnel syndrome. According to the Bureau of Labor Statistics, the median number of workdays missed due to carpal tunnel is 27. Cervical radiculopathy, ganglion cyst, tendonitis, De Quervain's Disease, and bursitis are other repetitive stress injuries that may be caused by office work.

Unlike in many other states, workers' compensation is mandatory for all employers in California. It does not matter if an employer has hundreds of employees or only one. It also does not matter if the injured employee was working full-time or part-time. Typically, self-employed individuals are not covered by the hiring entity’s workers’ compensation insurance. However, workers who have been misclassified as independent contractors may actually fall under the category of employee, which means that they would be entitled to coverage through workers’ compensation.

Individuals Who Are Not Covered by Workers Compensation in California

California has wider-reaching workers’ compensation coverage than many other states. However, there are still some individuals who are not covered by workers’ compensation, including:

Losing a relative in an unexpected work accident is a devastating experience to go through. If your spouse has recently passed away due to injuries he or she sustained on the job, you may still be figuring out what to do next. In the midst of your grief, you may also be trying to determine how you will make ends meet without your loved one’s financial support. In California, if a worker is injured in an on-the-job accident, the worker is typically entitled to financial compensation through workers’ compensation. If an employee is killed in a work accident, the worker’s dependents are usually entitled to compensation called death benefits. However, obtaining the compensation you need and deserve after losing a loved one in a work accident is often more complicated than many expect.

Workers’ Compensation Death Benefits in California

The compensation available can be for family members who were totally or partially financially dependent on the deceased worker. Some individuals are considered total dependents of the deceased worker. Minor children, disabled adult children, and surviving spouses with an annual income under $30,000 are automatically considered totally dependent on the worker. Stepchildren, spouses who make above the income threshold, grandchildren, parents, siblings, and other family members may qualify for death benefits. However, they will need to provide evidence that shows that they were partially or totally dependent on the deceased worker.

Not every workplace injury is sudden or caused by a specific event. Sometimes, injuries sneak up on workers gradually and develop over time. Repetitive exposures or activities on the job often lead to these conditions.Though many workers do not realize it, some are still entitled to workers' compensation benefits due to these injuries. A Santa Clara County or Gilroy, California workers' comp attorney can help you determine if you qualify. But first, you need to determine if you have one of these often overlooked workplace injuries.

Do I Have a Commonly Overlooked Workplace Injury

When an injury develops over time, workers and employers often overlook them. A few commonly overlooked work injuries include:

• Hearing loss. The National Institute for Occupational Safety and Health (NIOSH) claims that hearing loss is prevalent in noise-exposed industries. This can include jobs in construction, agriculture and forestry. Dangerous noise levels can damage eardrums, the bones in the ear or cause tinnitus. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), recurrent exposure to noise at 85 decibels or higher can cause hearing loss.
• Lung problems. Workers often breathe in particles from their workplace. This often exposes them to chemicals, dust, and smoke from the work environment. Eventually, these hazardous particles can break down lung tissue and cause problems. This is why workers in industries such as mining, agriculture, manufacturing and construction have a higher prevalence of asthma and lung disease.
• Musculoskeletal injuries. Musculoskeletal injuries can occur from repetitive motion and overuse. For example, jobs that require repeated lifting could lead to back injuries. Another common musculoskeletal injury is carpal tunnel syndrome. Cashiers, hairdressers and typists often suffer from this injury due to repetitive wrist movement. Repeating the same motion for your job often takes a toll on your joints. Over time, this type of work can cause inflammation, pain and even early arthritis. Generally, if you are repeating the same motion for your job, over time it could take a toll on your joints, causing inflammation, pain and even early arthritis.
• Stress and anxiety are silent dangers in the workplace. Stress can wreak havoc on the human body by raising blood pressure and weakening the immune system, making it more susceptible to injury. Chronic stress could lead to depression and other psychiatric issues or even heart problems.
• Psychological Injuries. California does recognize sychiatric injuries in its labor code. However, the worker must prove their psychiatric injury resulted predominantly from work, and their employer must have hired them at least six months prior to the claim. If a worker has been a victim of a violent act or has had direct exposure to a violent act over the course of their employment, then they must prove that at least 35 to 40 percent of their injury resulted from work.

Need to Speak With a Gilroy Workers Comp Attorney

At Cramer & Martinez, LLP, our workers' compensation attorneys help clients in Gilroy, Hollister, Morgan Hill and the surrounding areas of South County. We help you maneuver through the workers' compensation claim process for workplace injuries. Call us at (408) 848-1113 or fill out our online form to discuss your situation.

The COVID-19 pandemic impacted the majority of California workers significantly. Millions of people lost their jobs. Millions more worked from home during the statewide stay-at-home order. However, the government classified many employers as essential businesses. This forced many people to continue working despite the coronavirus pandemic. Examples of essential workers include:

• Nurses
• First responders
• Maintenance workers
• Warehouse employees
• Farm workers
• Grocery store workers
• And more

Were you one of these essential workers employed in Santa Clara County, San Benito County, Santa Cruz County or Monterey County If so, then you may have many coronavirus-related questions. For example, can you recover workers' compensation benefits after contracting COVID-19 on the job A recent Executive Order by Governor Newsome makes it easier for you to do so.

California Workers Compensation News

The California Labor Code allows for workers' compensation benefits in California under the following circumstances:

If there is a job-related incident that results in an injury to an employee, the event has to be logged under one of the code titles in the Occupational Injury and Illness Classification System, or OIICS. The OIICS is part of the Bureau of Labor Statistics, and it is designed to code the case characteristics of a job-related injury to an employee. Self-inflicted injuries, in relation to workers' compensation, is an injury that a worker does to himself or herself. This injury can be intentional or accidental, but it has its own claim process under workers' compensation regulations.

What Types of Jobs Result in High Amounts of Self-Inflicted Injuries

There are certain types of jobs that have a high risk for self-inflicted injuries. Some of these include:

• Law enforcement
• Medical employees
• Farmers
• Teachers
• Salespeople

Some common self-inflicted injuries that can occur from these jobs include cuts, scrapes, broken bones, internal injuries and serious head injuries.

Many individuals want to return to work after being injured because they enjoy the work they do what they love. Others want to return to work because they e seeking higher wages than provided by workers' compensation. Going back to work after a workplace accident is a process that includes your physician, employer, and claims administrator. It important that you receive approval from these parties to return to work promptly and safely.

What Determines My Ability to Work Again

It important to open lines of communication with the parties stated above for returning to work. Close contact throughout the proceedings will help you to get back to work quicker and easier. You must relay detailed information about the following to doctors, claims officials, and your employer:

• The workload you had before your injury
• Your medical condition and what work is possible now
• The type of work your employer can make available to you per your medical condition

When I Return to Work, What Can I Do

Your doctor will report to the claims administrator to determine if it safe for you to return to work. It may be possible for you to return to work while you e recovering. During your recovery, the doctor the must report the following to your claims official:

After suffering a workplace injury, you should visit your primary physician. If you need to file a workers' comp claim, your physician's notes will serve as documentation of your injuries. Sometimes, however, an independent medical examination is also required. An IME is usually requested by your employer's insurance company to confirm your primary physician's diagnosis. In either case, what you say to your workers' comp doctor can make or break your claim. Your statements will make it into the doctor's notes that will be later assessed as part of your claim. Our Hollister workers' compensation attorneys outline common mistakes to avoid below.

Common Mistakes to Avoid When Speaking With a Workers Comp Doctor

• Exaggerating your injuries. Your doctor needs to know the nature and extent of your injuries in order to treat them effectively. This cannot happen if you exaggerate, or even downplay, your condition. Further, if your doctor has doubts about the severity of your condition, they may not sign off on your workers' comp forms. Not only will an exaggeration affect the medical treatment you need, it may also seriously hurt your benefits claim. The best policy in this case should be honesty.
• Lying about or failing to disclose prior injuries. If you have a prior injury, you may worry that this will affect your claim. However, the worst thing you can do is hide or lie about this injury to your workers' comp doctor. You doctor will be able to find this information anyway, and it may come back to bite you later. Instead, being honest with your physician may actually strengthen your case. Your physician may be able to rule out a connection between your current and prior injury. Or, they may be able to document how your current injury worsened your prior condition.
• Providing inconsistent information. It is not uncommon for people to hurt their workers' compensation claims unintentionally. One way this happens is when people try to answer their doctor's questions without fully knowing the answers themselves. It is important to know that you do not have to guess or deduce the answers to your doctor's questions. If you do not know the answer, simply say so. Providing your best guess may result in inconsistent or inaccurate information that will later hurt your claim.

Need Help Filing a Claim Contact a Trusted Hollister Workers Compensation Attorney

The workers' comp attorneys at our firm have more than 50 years combined experience in this field. During this time, we have helped our clients navigate their claims and avoid these common mistakes at all stages of the process. This includes applying for benefits, appealing a denial, negotiating with employers and insurance companies, and fighting back against discrimination in the claims process. If you need help in securing your benefits, contact our offices today to learn more about our services. To schedule a free consultation, give us a call at (408) 848-1113 or send us a message online.

Workers’ compensation benefits can help an injured worker pay for medical expenses and other costs related to a work injury. However, filing a workers’ compensation claim and successfully recovering benefits is often more difficult than many workers expect. If your workers’ compensation claim was denied, you may be worried about how you will pay your bills and receive the medical care you need. Fortunately, you may be able to appeal a workers’ compensation denial.

Determining the Reason for Workers’ Compensation Denial

If you or your loved one was denied workers’ compensation after a work accident, you may be confused and unsure as to why the claim was denied. Workers’ compensation claims are denied for many reasons. In some cases, the insurer or employer may simply not have received enough information about the injury to make a proper assessment about workers’ compensation benefits. Mistakes made on the part of the injured worker or the insurer/employer may also lead to delays or denials. Workers’ compensation benefits are contingent on the injured worker meeting specific filing requirements and deadlines. The insurer or employer may also deny you if the way you were injured makes you ineligible for benefits. Injuries that occur while a worker is under the influence of drugs or alcohol, self-inflicted injuries, injuries caused by a preexisting condition, or injuries that are unrelated to work are not typically covered by workers’ compensation. Employers or insurance companies sometimes wrongfully deny workers’ compensation claims.

Appealing the Decision

If you were denied coverage under California workers’ compensation laws, you have the option of appealing the decision. To do so, you must file a form called a “Declaration of Readiness to Proceed.” You may then attend a hearing with the Worker’ Compensation Appeals Board (WCAB) and argue your case in front of a judge. A workers compensation lawyer can help you fight for the benefits you need. Your lawyer will help you use medical records and other evidence to demonstrate your eligibility for workers’ compensation and represent you during the hearing. If a settlement cannot be achieved, your attorney can also represent you during trial.

Part-time workers get injured on the job just like full-time employees. As such, they suffer the same types of expenses and losses. Yet, many part-time workers believe that they cannot collect workers' compensation. Fortunately, this is untrue. In California, part-time workers are eligible to receive workers' compensation benefits. However, there are a few notable exceptions. Thus, it is important to speak to a Gilroy workers' compensation lawyer. He or she can help you understand your rights to compensation after a work-related injury.

Understand How California Workers Compensation Coverage Works

First, it is important to understand how California workers' compensation law protects injured workers and employers. First, employers must provide these benefits to employees who suffer an injury at work. Employees benefit because they do not have to prove liability or wrongdoing to obtain these benefits. The employer benefits by avoiding personal injury lawsuits when workers suffer an injury in their facility. However, there are some rules and requirements for collecting workers' compensation.Additionally, receiving workers' compensation in California is not a guarantee. For example, not all workers can receive benefits through the workers' compensation system, including:

• Sole proprietors with no employees
• Employer's spouse or children
• Volunteers
• Independent contractors

How Can I Determine if I Am a Part-Time Employee or Independent Contractor

Fortunately, part-time and seasonal employees can receive workers' compensation benefits in California. However, you may need help determining if you are a part-time employee or an independent contractor. Essentially, it is up to your employer to decide job classifications. There are no legal guidelines that determine if you are a part-time employee or a full-time employee. However, the Bureau of Labor Statistics (BLS) says that a worker who works under 35 hours a week is considered a part-time employee.Also, as an employee, it is important to understand that businesses and managers do not always play fair. For example, they may attempt to convince part-time workers that they cannot collect workers' compensation benefits after an accident. They may even misclassify an employee and claim that he or she is an independent contractor instead of a part-time employee. When this occurs, injured workers need someone on their side who can fight for their rights.

Independent Medical Examinations (IME) are often required for you to attend if you e been injured in a workplace accident. This is a separate examination outside of your examination to your regular treating physician. IMEs are requested by worker compensation insurance providers when there is a disagreement with your treating physician about work-related injuries. This examination is performed by medical professional that will provide their expert opinion on any disputes in your claim.

Before the Exam

Here are some vital tips for preparing for your exam:

• Know the disputed information. The insurance company will send a report to the IME physician about your report injuries and illness related to the work injury claim. Requesting the letter and reviewing before hand is a good way to ensure you e on the same page with the IME medical professional.
• Be up to date on your medical history. Make sure that you know your medical history, including surgeries, medications you are taking or any other pre-existing conditions. The IME doctor will inquire about all your medical history. This may help you in your claim disputes.
• Detail the events of the accident. Review the incident and practice saying what happened before, during, and after the accident. It important for you remember all the details of the event. The IME doctor will be recording any changes in your story and it may be used in your dispute claim.
• New symptoms. Many injuries you sustain can have continuing symptoms after the accident. Make sure to review your symptoms and pre-existing injuries to make sure you aren having any new symptoms.

What to Expect During the Exam

During the exam, it important to remember the above information as well as the following:

Although accidents do cause workplace injuries, there are other ways that you can be injured while working. For example, sitting for long hours at a desk and looking at a computer monitor for an extended period can cause bodily harm. Soft tissue injuries, back pain and neck issues are just some of the injuries that can occur after spending too much time in uncomfortable work positions. In addition, repetitive motions can lead to carpal tunnel syndrome, tendinitis and other painful conditions. Fortunately, there are ways that you can lessen injury in the workplace. If you consistently spend long hours at your desk, then you should consider these work space modifications.

Adjusting Your Chair

It is important for your office chair to accommodate your height and posture. Therefore, you should adjust your chair to help you sit properly with both feet on the floor or on a footrest. Also, keep your thighs parallel to the floor to alleviate back pain.

Moving Your Keyboard

Along with office chairs, many office employees use keyboards on a daily basis. As a result, many people experience pain in their wrists and fingers. To reduce the risk for carpal tunnel, keep your keyboard lying flat always. Also, keep your wrists parallel to the floor and resist the urge to lean forward when typing.